Stalk begins with a dimple in the occipital or nasal region. Cutaneous stigmata of hemangioma, subcutaneous dermoid cyst, or abnormal hair formation may occur. Occipital sinuses extend caudally, and if they enter the skull, they do so caudal to the torcular herophili. Presentation may include recurrent bacterial (usually S. aureus) or aseptic meningitis. Evaluation should include MRI to look for intracranial extension and associated anomalies, including an intracranial dermoid cyst.